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ÇOCUKLARDA DOĞUMSAL DİYAFRAGMA BOZUKLUKLARI: 15 YILLIK DENEYİM

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2003

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Abstract (2. Language): 
SUMMARY Congenital diaphragm anomalies in chiîdren: 15 year's expeıîence. For thc purpose of evaluating tlıe characleristics of patients whom had an operation duc to congenital diaphragm anomaly and assessment of the results of the treatment rcceİved, records of 76 cases that had a surgical operation after being diagnosed at our hospital between 1987-2002, arc retrospcctİvely studied. Surgical operations were performcd on patients due to Bochdalek hernia İn 52 cases (68%), event-ration of thc diaphragm in 15 cases (20%), and Morgagni hernia in 9 cases (12%). Ali cases wcrc diagnosed by ehest rontgenogram, and were confirmed by gastrointestİnal scrİcs and/or by the ult-rasonographic examination. There were associated several anomalies in 13 cases. The cases of Bochdalek hernia that ages of applied persons vary bctwccn 8 hours and 6 years were 32 in male and 20 in female, 48 in the left side and 4 in the right side. 11(2 İ%) of those cases that became semptomatic in the first day of life died, thc other 2 had surgical operations again due to recurrent hernia. The eveniration of thc diaphragm cases of 1,1 years age averagc wcre 11 in male and 4 in female and the eventratİons were right sided in 13 cases and left sided in 2 cases. For ali of cases, diaphragm plications were done and any problem was observed. Cases of Morgagni hernia of 1,6 years age average were 7 in male, 2 İn female and the protrusions were bilatcral in 6 cases, left sided in 2 cases and right sided in another case. One (11%) of the cases that a primary repair was performed in ali, dİed and thc other needed a surgical operation again due to recurrence. As a conelusion, the methods of diagnosis and treatment were almost standardized in the congenital diaphragm anomalies. However, in spite of tcchnological improvements, the mortality rate is presently high in especially Bochdalek hernias.
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Abstract (Original Language): 
Doğumsal diyafragma bozukluğu nedeniyle ameliyat edilen hastaların özelliklerinin ve tedavi sonuçlarının değerlendirilmesi. 1987- 2002 yılları arasında hastanemizde tanı konarak ameliyat edilen 76 olgunun kayıtları geriye dönük olarak incelendi. Olguların 52'si (%68) Bochdalek fıtığı, 15'i (%20) diyafragma evantrasyonu ve 9'u (%12) Mor-gagni fıtığı nedeniyle ameliyat edildi. Tanı tüm olgularda akciğer filimi ile kondu, baryumlu mi-de-barsak grafileri ve/veya ultrasonografi ile de doğrulandı. On üç olguda eşlik eden diğer organ-sistem bozuklukları vardı. Olguların izlem süresi 9 ay - 15 yıl arasında değişiyordu. Başvuru yaşları 8 saat- 6 yaş arasında değişen Bochdalek fıtıklı olguların 32'si erkek, 20'si kızdı; fıtık 48 olguda sol, 4 olguda sağ tarafta idi. Kırksekizİnde primer, 4'ünde emilebilir ağ (Vicryl mesh) ile onarım yapılan bu olguların tümü ilk 24 saat içinde belirti vermiş olan ll'i (%21) kaybedildi, 2'sİ nüks nedeniyle yeniden ameliyat edildi. Yaş ortalaması 1.1 yıl olan diyafragma evantrasyonu olgularının İl'i erkek, 4'ü kızdı, evanlrasyon 13 olguda sağ, 2 olguda sol tarafta idi. Olguların tümünde diyafragma plikasyonu yapıldı ve iz-lcmdc sorunla karşılaşılmadı. Yaş ortalaması 1.6 yıl olan Morgagni fıtığı olgularının 7'si erkek, 2'si kız olup, fıtık 6 olguda iki taraflı, 2 olguda solda, 1 olguda ise sağda idi. Tümünde primer onarım yapılan olgulardan biri (%11) kaybedildi, birinde İse nüks fıtık nedeniyle yemden ameliyat gerekti. Doğumsal diyafragma bozukluklarında tanı ve tedavi yöntemleri hemen hemen standart hale gelmiştir. Ancak tüm teknolojik gelişmelere karşın özellikle Bochdalek fıtıklarında ölüm oram halen yüksektir
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  • 3
154-159
  • Turkish

REFERENCES

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